Not all 40 million uninsured wronged

February 3, 2004

Tibor Machan

The figure of 40 million people lacking health insurance in the United States is bandied about so much it deserves to be discussed a bit, even by a non-expert such as myself. What exactly does it mean?
The implication for most who mention this figure is the federal government must do something to insure these 40 million people. That is, of course, a blatant non-sequitur.
Given that health insurance costs money — money that enables people to pay for doctor visits, hospital stays, lab tests, etc. — the government would have to obtain the funds from citizens, via taxes, to provide it to the 40 million. So, this figure is usually deployed to advocate more spending by the government based on more taxation. That alone should make one suspicious about the figure, since in the service of more government largess, advocacy groups tend to exaggerate their needs.
But let us leave aside the veracity of the figure itself. The first question that can be raised is how long are the 40 million uninsured? I used to be uninsured all through my adolescence, after I ran away from home, until I enlisted in the Air Force. Then after I got out, I was again uninsured for years. Only after I got a steady job did health insurance benefits come along, usually for a reasonable price.
But what if someone is paranoid about getting sick? Or what if one is quite healthy? That would mean those types of individuals are getting insurance they probably don’t yet need. Sure, some unexpected illness could strike, and that’s in part what insurance is for. But it is not clear that everyone, even those with robust health, require insurance rather than savings so as to prepare for such unexpected illnesses.
Then, also, some folks do not work hard enough to be able to afford to take care of their health needs. This is an idea that many public-minded people may find odd. But getting insurance, like getting anything else, costs money. If you do not make any money, well you must do without.
Most of us do not have enough money for a boat, or for going skiing or hundreds of other things, but because we work steadily enough — which is not an effortless feat and one that many refuse to attain — we manage to afford health insurance.
How many folks refuse to get into “the rat race,” which then leads to, among other things, their not having health insurance?
As usual, there is the problem with children. Kids are often brought into the world by irresponsible parents who cannot afford to care for them, which includes the inability to provide sufficient health care for them. So, while these parents ordinarily deserve zero tolerance as far as pity and compassion, the kids are another story. Here is where charity, generosity, philanthropy and other kinds of voluntary aid come into the picture.
But this isn’t a task for our legal authorities, who already have a job to perform and do it rather ineptly, sad to say.
I am sure this approach will not solve the problem for all. Yes, a part of the solution is to acknowledge some folks do not deserve health insurance, so we shouldn’t consider it some kind of societal failure that they have none.
But there may well be some left, even if we factor in all the relevant considerations, who are doing their best and still are uninsured. And even the charitable organizations may not be up to helping some of these.
Life does not guarantee perfect satisfaction for all, even in meeting elementary needs. But before we conclude that our society is in desperate straights because 40 million lack health insurance, let’s look at the figure in full context and consider what it may or may not mean.
It may well be those 40 million people are not the same ones from month to month, year to year, but switch places all the time.
So, very possibly, many of the 40 million uninsured are, in fact, uninsured for good reasons — they fail to work hard enough to afford it, or they really don’t need it for significant stretches of their lives.

Tibor Machan advises Freedom Communications, parent company of this newspaper. E-mail him at :
Machan@chapman.edu